The University of Queensland's Endocrine Hypertension Research Centre is based at Greenslopes and Princess Alexandra Hospitals. The Centre is a major clinical referral centre for the management of hypertension and our research investigates:
endocrine varieties - especially primary aldosteronism (PA),
renin-secreting tumors, and
the syndrome of hypertension and hyperkalemia with normal glomerular filtration rate, also known as hereditary hyperkalemic hypertension,
pseudo-hypoaldosteronism type 2 or Gordon's syndrome (named after the Centre's founder).
The Centre has in recent years placed particular emphasis on epidemiological, biochemical, morphological and genetic aspects of primary aldosteronism (PA) and has attracted much attention for its work in this area. It demonstrated 19 years ago that this potentially curable condition is approximately ten times more common than previously thought, a finding which has led to the identification of thousands of patients who would otherwise have gone undetected, and in whom hypertension has been cured or markedly improved following surgical or specific medical treatment. It also described the phenotypic characteristics of a common but rarely recognised tumorous form (angiotensin-II responsive aldosterone-producing adenoma) and a new and more common familial variety (familial hyperaldosteronism type II, FH-II). It has contributed to the diagnosis, pathophysiology and treatment of the first described, rare, familial form of PA (FH-I) which is glucocorticoid-remediable.
Research at the Centre has demonstrated evidence of non-blood pressure related adverse cardiovascular effects of aldosterone excess in normotensive subjects with FH-I in collaboration with Professor Tom Marwick, University of Queensland Department of Medicine, Princess Alexandra Hospital using state-of-the-art echocardiographic techniques to study fibrosis and remodelling of the heart. Ongoing studies are focussing on the interaction of aldosterone and salt in the generation of disease states (including cardiac hypertrophy, renal damage and obstructive sleep apnoea) in patients with PA.
Current Research Focus
Determining the genetic basis for familial hyperaldosteronism (FH)-II and other forms of primary aldosteronism (PA)
Validating a highly accurate method of measuring aldosterone using tandem mass spectrometry developed within the centre
Determining genetic factors which may modify phenotypic expression in FH-I, and thereby explain the wide spectrum of hypertension
Determining the extent to which aldosterone excess in humans is capable of causing cardiovascular and other organ dysfunction
Examining the effects of gender and phases of menstrual cycle on diagnosis and sub-typing of PA (by fludrocortisone suppression testing and adrenal venous sampling respectively).
Investigating the effects of menopause and hormonal replacement therapy on detection of PA
Comparing the efficacy of saline suppression testing (recumbent vs upright) vs fludrocortisone suppression testing in diagnosing PA.
The Centre has co-directors in Prof Michael Stowasser and E/Prof Richard Gordon. E/Prof Gordon established the Hypertension Unit and the Endocrine-Hypertension Research Unit (later to become the Centre) at Greenslopes Hospital in 1970 and has over 40 years of clinical and research experience in the pathogenesis, diagnostic workup and management of various forms of hypertension and especially of endocrine varieties. In 1994 Professor Gordon was made an Officer of the Order of Australia (AO) for his contributions to medicine, especially in the area of endocrine hypertension. Prof Stowasser has over 25 years research experience and a PhD in endocrine hypertension and is Director of the Hypertension Unit at Princess Alexandra Hospital where the Centre's laboratory is currently based. He is also current Director of the Hypertension Unit at Greenslopes Hospital.
Our Clinical Expertise
Four Hypertension Clinics weekly (three at PAH and one at GH) plus referrals from private rooms provide a sophisticated diagnostic and treatment service for patients from all over Queensland and Northern NSW, with occasional referrals from further afield including Sydney, Melbourne, Tasmania and Asia. Detailed and rigorous inpatient (in demarcated "Hypertension Unit" beds) investigation and treatment protocols are closely supervised by dedicated "Hypertension Unit" nurses. More than 1500 thoroughly studied and documented patients with PA provide a unique resource for further research into causes, diagnosis and treatment, and have led to important collaborations with first-class overseas investigators.
The Centre offers opportunities for training of both Medical and Science graduates in hypertension investigation, treatment and research which is both applied and basic, with clinical relevance, in selected cases leading to the award of a PhD.